Super oblique tendon elongation with fascia lata.
OBJECTIVE
Superior oblique lengthening with a silicone retinal band is used to treat superior oblique overaction (SOOA); however, secondary infection, implant extrusion, orbital cellulitis, and adhesion may occur. We present a method of superior oblique tendon elongation in which autogenous fascia lata is used to decrease the likelihood of these complications.


METHODS
Six patients (5 female, 1 male) aged 7-22 years (mean, 17 years) with 40-85(Delta) exotropia and SOOA (range, +2 to +4; mean, +3.5) underwent bilateral superior oblique lengthening with insertion of fascia lata. In the last 2 cases, the values of elongation were augmented by 2 mm. Fascia lata was harvested through a linear incision on the lateral aspect of the patient's thigh.


RESULTS
Postoperatively, correction of A-pattern exotropia to within 10(Delta) was achieved in 66% of the cases as well as correction of SOOA to within +1 in 58% of the cases, with a follow-up of 9 months. All patients with +2 to +3 SOOA (3 cases) were fully corrected, whereas those with +4 SOOA (9 eyes) had residual overaction of +1 to +3. In the 4 eyes with augmented elongation, residual SOOA was between 0 and +2. No patient developed superior oblique palsy.


CONCLUSIONS
Autogenous fascia lata may be used as an alternative to a silicone band for superior oblique lengthening. Our results were comparable with published results for the silicone band, with a lower rate of overcorrection. The improved biocompatibility makes it likely that autogenous fascia lata will have a lower complication rate than with a silicone band.
Talebnejad
Mohammad Reza
MR
Ophthalmology Department, Shiraz University of Medical Sciences, Shiraz, Iran. talebnejadmr@yahoo.com
Eghtedari
Masoomeh
M
Owji
Naser
N
Alavi
Alireza
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005099:Exotropia / Q000503:physiopathology* / Q000601:surgery*; D005206:Fascia Lata / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000503:physiopathology*; D011446:Prospective Studies; D013710:Tendons / Q000601:surgery*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult